January 3, 2012 - by By Dr. Julio Montaner, Director, BC Centre for Excellence in HIV/AIDS, past President of the International AIDS Society, Professor of Medicine and Chair of AIDS Research at UBC

Dr. Montaner is the organizer and a speaker for the AAAS symposium, Toward the Control of HIV and AIDS Through Comprehensive Treatment as Prevention, Sunday, February 19th 10 – 11:30 a.m., followed by a topical lecture on the same topic.

As of December 1, 2011, World AIDS Day, two campaigns were underway in British Columbia to encourage residents to get tested for HIV and, in the process, help defeat HIV/AIDS. Vancouver Coastal Health and Providence Health Care have recently launched a comprehensive social marketing campaign called “It’s Different Now” to promote routine HIV testing, while the BC Centre for Excellence in HIV/AIDS (BC-CfE) launched its Treatment as Prevention campaign. Together, these innovative programs provide a vital call to action that is not only being heard in B.C., but in Canada and around world.

Voluntary, confidential testing will identify and help people with HIV receive the treatment they require. Approximately 2,500 people in B.C. from all walks of life have HIV and are not aware of their status, so it is critical that testing be implemented province-wide.

2,500 people in B.C. are unaware of their HIV status

The B.C. testing campaigns are being closely watched by the international health community. Stephen Lewis, founder of the Stephen Lewis Foundation which provides care and support to people living with HIV and AIDS in Africa, has said, “The eyes of the world will again be on B.C. as it moves to normalize HIV testing and make it the mainstream medical intervention it should be. The BC-CfE campaign can help show that it is possible to defeat HIV and AIDS using Treatment as Prevention as a cornerstone strategy.”

The BC-CfE’s Treatment as Prevention strategy involves administering anti-HIV drugs known as Highly Active Antiretroviral Therapy (HAART) to medically eligible people testing positive for HIV. The benefits of HAART treatment are two-fold: It reduces the level of HIV in the blood to undetectable levels, improving the health of people with HIV, and also decreases the level of HIV in sexual fluids to undetectable levels, reducing the likelihood of HIV transmission by more than 95 per cent.

Implementation of the Treatment as Prevention strategy has dramatically reduced AIDS deaths and new HIV diagnoses in B.C. A total of 301 new HIV diagnoses were made in 2010, a reduction of nearly 65 per cent from the 850 cases diagnosed annually prior to 1996. In fact, B.C. is the only province in Canada demonstrating a consistent, steady decline in new HIV diagnoses.

B.C. is now the only province showing a decline in HIV diagnoses

The Treatment as Prevention strategy was pioneered, modeled and proven in B.C. by the BC-CfE, which is based at St. Paul’s Hospital, a teaching hospital of the University of British Columbia. Publicly introduced to the world in 2006, the Treatment as Prevention model is now considered a game-changer in the fight against HIV and has been adopted as a key plank to reach US Secretary of State Hillary Clinton’s goal of an AIDS-free generation.

In addition, leading global health organizations such as the International AIDS Society, UNAIDS, and the Clinton Foundation continue to endorse rapid expansion of Treatment as Prevention programs around the world and are urgently requesting more funding for them.

Treatment as Prevention is a game-changer

Following B.C.’s lead, other countries are implementing Treatment as Prevention initiatives. China is launching Treatment as Prevention as a national program to help the country meet its goal of bringing HIV and AIDS under control by 2015. Swaziland, a country with the world’s highest HIV rate, is planning to implement the first full-scale national trial of Treatment as Prevention in a poor developing nation. Recently, the Globe and Mail newspaper said the made-in-B.C. Treatment as Prevention strategy could be a key to ending the epidemic.

However, with Treatment as Prevention, it all starts with widespread, routine testing. The It’s Different Now (www.itsdifferentnow.org) and Treatment as Prevention (www.treatmentasprevention.ca) campaigns are leading efforts in B.C. to move HIV testing beyond what are considered at-risk groups and into the mainstream. Only through comprehensive programs that normalize HIV testing for all British Columbians will we optimize our efforts and resources to defeat HIV and reach our shared goal of an AIDS-free generation.